Protection For Hand Eczema: Department of Dermatology

Oxford University Hospitals
NHS Trust
Department of Dermatology
Protection for
hand eczema
Information for patients
What can I do to help my hand eczema?
Hand eczema (the same as hand dermatitis) is normally caused
by a combination of factors. This includes having sensitive skin,
or an irritation or allergy to things that you might touch. Anyone
can develop hand eczema, and it often develops if your hands
have been wet for long periods of time or they have come into
contact with an irritant. People with ‘sensitive skin’ can develop
hand eczema with very little exposure, others will only develop
problems after much greater exposure to these conditions. If you
have had eczema in the past, or have asthma or hay fever, you
are more likely to develop hand eczema.
Skin protection is a very important aspect of your treatment. This
leaflet will give you information on how to protect your skin,
how to help your skin recover and how to reduce the risk of
further problems in the future.
What are irritants?

We are all exposed to irritants every day. Examples of irritants
include repeated wetting of the skin, soaps, detergents, bleaches,
disinfectants, shampoos, polishes, adhesives (glues) and solvents.
Some foods and vegetable juices can also irritate the skin, so it
can be very difficult to completely protect sensitive skin.
Information for patients 2

How should I wash my hands?
When washing your hands, use a very mild fragrance-free soap
and tepid (slightly warm) water. Wet your hands before applying
the soap. Use only a small amount of soap as even ‘mild’
products are still irritating to sensitive skin. Take your rings off
before washing as soap can get trapped under them.
If your skin is very sensitive you can use a soap substitute to wash
your hands, such as Dermol 500 or emulsifying ointment.
Make sure that you rinse your hands thoroughly if you use soap,
and carefully dry your skin after washing. Pay particular attention
to drying between your fingers. Always apply a moisturiser or
fragrance-free hand cream afterwards.
How can I avoid contact with cleaning agents

and detergents?
Many substances around the home and in the workplace are
irritating to skin, such as soaps and detergents (e.g. washing up
liquid).
• Always use gloves (see next page) when washing up, or
persuade someone else to wash the dishes.
• If you have young children or a baby, avoid contact with
sterilising solutions and use disposable nappies for your child.
Wear gloves when bathing your child or washing their hair.
• Beware polishes of all types, as they contain solvents and
other irritants which can badly aggravate your skin. Solvents
are also found in many other household products, e.g. white
spirit, nail polish remover, paint thinners and dry cleaning
fluids.
• Protect your hands when washing your hair by using gloves, as
shampoos contain a large amount of detergent.
• Always wear gloves when hand washing clothes, as washing
powders will always aggravate your skin.
Do I need to take any special precautions
when preparing food?
Some foods are irritating to the skin when handled, so it is best
to wear gloves when preparing them. Potatoes, onions, garlic and
tomatoes can irritate the skin. The peel and juices of oranges,
lemons and other citrus fruits are especially irritating. Some
people also have problems with making pastry and preparing
raw meat and fish.
Which gloves should I wear and when?

Protect your skin from direct contact with soaps, detergents
and bleaches by wearing gloves, either disposable or reusable.
Vinyl gloves or “hypoallergenic gloves” are better than normal
rubber gloves, as you may become allergic to the rubber. Buy a
number of pairs, so that you can have them easily available in
different areas where you carry out wet and dirty work. If they
become punctured (develop a hole), immediately replace them;
a punctured glove is worse than no glove at all, as it can trap
potential allergens and irritants between the glove and your
skin. Thin vinyl disposable gloves are the best gloves for food
preparation.
Buy a few pairs of cotton gloves for dry work and, if you wish, as
a liner for your other gloves. Cotton gloves are also useful to wear
after you have applied a thick layer of moisturiser (emollient).
This will allow your skin to be thoroughly moisturised, while
keeping your furniture, books etc. free from mess.
If you need to wear gloves at work, your employer has a responsibility
to make sure that the correct type of glove is provided for the
task. Try to avoid wearing gloves for very long periods of time.
During cold or windy weather, make sure you wear gloves when
out doors to prevent your skin from drying and chapping.

Moisturisers
Use a good moisturising cream after hand washing and as
frequently as possible (a minimum of 4 times a day). Avoid
perfumed moisturisers, as perfume (fragrance) allergy is
common. Also, if your dermatologist has advised you of any
other allergies they have identified as a result of skin tests, avoid
these substances too.
Health workers
If you work in the hospital or community then repeated hand
washing and prolonged wearing of gloves may be a particular
problem for you. Regularly moisturise your hands after washing
and before and after work. Moisturise your hands regularly at
work with Dermol 500 or another moisturiser, e.g. Cetraben
or Diprobase. Your manager should be able to provide this for
you. Use a greasier emollient after your shift and at home, e.g.
Hydromol, Epaderm or emulsifying ointment.
If you have dry skin or dermatitis of the hands, avoid the
liquid soaps provided on the wards and use Dermol 500 as
a soap substitute instead. Dermol 500 contains antiseptics
with antibacterial properties active against a wide spectrum of
bacteria, including methicillin resistant Staphylococcus aureus
(MRSA).
Use the alcohol hand rubs instead of full hand washing for
infection control purposes, as much as possible. However, if
these cause stinging and discomfort, wash your hands using
Dermol 500 as a soap substitute instead.
Bear in mind that alcohol gel cannot be used when caring for
patients with Clostridium difficile or diarrhoea of unknown origin
or if your hands are visibly dirty.

How long should I continue to follow these
instructions?
Continue all of these protective measures for at least four months
after your eczema has settled. Your skin will remain sensitive to
irritation for a long time after it appears to have fully healed.
Further information
For work related skin disorders:
Website: www.hse.gov.uk/skin
For information on hand dermatitis for health workers:
Website: www.nhshealthatwork.co.uk/dermatitis.asp
For general information:
Website: http://dermnetnz.org/doctors/dermatitis/hand.html
Contact number for the Dermatology Outpatient Department:
Tel: 01865 228 283
(9.00am to 5.00pm, Monday to Friday)

If you have a specific requirement, need an interpreter,
a document in Easy Read, another language, large print,
Braille or audio version, please call 01865 221 473
or email [email protected]
Authors: Dr Susan Cooper, Consultant Dermatologist

Gorav Wali, Dermatology Specialty Registrar
September 2015
Review: September 2018
Oxford University Hospitals NHS Trust
Oxford OX3 9DU
www.ouh.nhs.uk/information
OMI 12496P

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Oxford University Hospitals

What are irritants?

Information for patients 2

How can I avoid contact with cleaning agents

Which gloves should I wear and when?

Information for patients 4

Information for patients 5

Information for patients 6

Authors: Dr Susan Cooper, Consultant Dermatologist

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